Przegla̧d lekarski
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During the past 10 years, we have treated 11 patients who were admitted with acute respiratory failure due to goiter. Multinodular goiter was examined in four patients, one patient suffered from Graves disease and six patients had malignant thyroid lesions. Four patients required emergency intubation and in two cases we performed tracheostomy because of significant narrowing of trachea lumen. ⋯ The goiters with progress of trachea compression symptoms should be operated in elective surgery to avoid sudden life-threatening complications like severe dyspnea. When the hoarseness is present the possibility of malignant goiter is particularly high. In our opinion patients with suspected respiratory failure should be referred to the centres with special interest in thyroid surgery.
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Comparative Study
Frequency and clinical course of acute carbon monoxide poisoning in relation to the kind of emission gas.
The conversion of domestic supply from illuminating to natural gas in 1975 in Kraków was expected to diminish, or even eliminate the threat of CO intoxication. The aim of the study was to compare the frequency and clinical course of CO poisonings (early or delayed medical complication or death) regarding the source of CO (illuminating or natural gas). Under analysis there were adult inhabitants of Kraków treated at the Department of Clinical Toxicology from 1972 to 1974 when the main source of CO was illuminating gas and those treated from 1994 to 1996 i.e. after the conversion of domestic gas supply from illuminating to natural gas. ⋯ The conversion of domestic supply from illuminating to natural gas significantly decreased the mortality rate. No differences in the number of patients suffering from medical complications were found between the two study periods. A higher incidence of late sequalae (psychoorganic and depressive syndromes) was found in the group of patients poisoned with CO produced by incomplete combustion of natural gas compared to illuminating gas.
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Clinical Trial
[Clinical observations concerning piracetam treatment of patients after craniocerebral injury].
Piracetam (Nootropil) is a cytoprotective to brain tissue and improving cerebral blood flow medicine. In the Department of Neurotraumatology we investigated results of piracetam treatment in a group of 100 succeeding patients admitted between 1995-96 due to craniocerebral injury. High doses (24-30 g per day) of this medicine have a positive effect on final result of treatment, when treatment is initiated immediately after the injury and described conditions are abided. We also showed usefulness of piracetam treatment in posthospital management.